Tag Archives: Prehospital 12-Lead ECG blog

88 year old female: Weakness – Discussion

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This is the discussion for 88 year old female: Weakness. If you've not read the backstory, we suggest you check it out! When we last left off, our patient was in an exam room with an irregularly irregular rhythm. The ED physician had asked you if the patient had a history of atrial fibrillation. Let's […]

88 year old female: Weakness

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This great case was submitted by Vince DiGiulio, EMT-CC; we highly recommend you read his wonderful blog The Medial Approach to Emergency Medicine. As usual, the case has been altered to protect patient and provider privacy. You're working triage in a busy urban ED when an 88 year old female is brought in by her family. […]

Discussion for 51 Year Old Male: Chest Pain

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Here is the conclusion to 51 year old male: Chest Pain. You may wish to review the case. Here is the ECG again:   There is a regular sinus rhythm at a rate of about 70. The QRS is narrow. The axis is normal, at about 15 degrees. Let's take a look at the constellation […]

65 year old male CC: Fall with injury – Conclusion

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This is the conclusion to 65 year old male CC: Fall with injury. You may wish to review the history and clinical presentation. When we left off the patient was in severe heart failure with the following 12-lead ECG. As we have mentioned before on several occasions, the most important thing when treating a patient […]

65 year old male CC: Fall with injury

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Here's a very interesting case submitted by a faithful reader who wishes to remain anonymous. Some changes have been made to preserve patient confidentiality. EMS is called to a local breakfast restaurant for a 65 year old male who fell in the parking lot. He was reported to have suffered a head injury. On arrival […]

"What Happened?"–Discussion

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This is the discussion to "What Happened?" You may wish to review the case here. Ok, let's review the initial 12 Lead: Just about everyone picked up on the infero-posterior STEMI. Where it got interesting for me, was determining what the rhythm was! At first glance, the rhythm was for the most part regular (note […]

Snapshot: 32 year old male–chest discomfort

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Here's a new snapshot case straight from the UK… We have a 32 year old male, normally fit with no history whatsoever. He has had a stressful week (personal issues), and decided maybe a 4 mile run might help. It didn't. When he returned home, he developed sudden onset of chest discomfort, and decided to […]

69 year old female CC: Shortness of breath, weakness

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Here's a case submitted by a faithful reader who wishes to remain anonymous. He has submitted several cases before and they are always excellent so thank you, Mr. Anonymous!  EMS is called to the residence of a 69 year old female who is complaining of sudden onset of shortness of breath and weakness. Past medical […]

63 Year Old Male: "Dental Pain"

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Here is an interesting case submitted by Adam Frederick, NREMT-Intermediate.  As usual, some details have been changed to protect patient confidentiality. EMS is called to the local Urgent Care for a 63 year old male complaining of upper jaw pain related to "dental work". He had made two trips to the dentist this past week […]

Team EMS 12-Lead brings home Judges' Choice for 2012 EMS Blog of the Year

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On behalf of Team EMS 12-Lead (Tom Bouthillet, David Baumrind and Christopher Watford) I am pleased to officially acknowledge that the EMS 12-Lead blog won Judges' Choice for 2012 EMS Blog of the Year. This contest was hosted by EMS1, FireRescue1 and FireCritic.com and sponsored by the American Military University. The total list of nominees can be found here. Lots of […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
David Baumrind
All that wiggles isn’t Wellens’
@Gary, by all means, nitpick all you like. I agree with your assessment, and the post has been modified. Thank you for the feedback!
2014-08-30 17:28:16
Gary Huntress
All that wiggles isn’t Wellens’
Not to nitpick but is this really a "slightly leftward axis"? I and AVF are both positive. I put it at about +20 degrees, not leftward.
2014-08-30 11:49:35
Handsome Robb
87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA
CHF. 12-lead shows a sinus Tachycardia in the 120s with PACs, besides the anterior leads there's diffuse ST depression, the STE in the anterior leads can be explained by the LBBB, axis is good as well. I wish they posted the EtCO2 waveform so we could see but I'm assuming it's non-obstructive. The elevated EtCO2…
2014-08-30 08:08:22
Christopher Watford
“Bad heartburn” – 82 y.o. female without chest pain.
Brooks, Firstly, thank you for the warm welcome to the club. Secondly, the Glasgow algorithm's only published sens/spec for AMI is 51.6%/97.6% respectively (Tuscon STEMI Database). I've not been able to find any other publications. The GE Marquette 12SL algorithm has been widely studied, but is much older, and ranges in sensitivity from 48% to…
2014-08-29 16:50:14
CB
57 Year Old Male–Chest Discomfort
Given what he was doing (paint fumes on ladder painting) I would first question if the pain is reproducable. Yes his ekg isn't normal but looks like old inferior MI. And he is hypertensive. 02 a must. Def. would give ASA. First would give morphine and see how his cp and bp are. If still…
2014-08-29 11:37:25

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